Alexander Rivkin, MD - Cosmetic Surgeon in Los Angeles, California

Eva Sheie (00:03):
Whether you're trying injectables for the first time or making a change to a new provider, the more you can learn about who your injector is before you're in the chair, the better that appointment will be. You are listening to Meet the Injector. My guest today is Dr. Alex Rivkin and he's the founder and pioneer behind West Side Aesthetics in Los Angeles. Welcome to the podcast.

Dr. Rivkin (00:27):
Thanks. It's nice to be here. Appreciate it.

Eva Sheie (00:29):
It's nice to see you again.

Dr. Rivkin (00:32):
Indeed. It's been a while.

Eva Sheie (00:34):
Yes. So tell us how you got started and how you started it specifically in aesthetics, in the most competitive market on the planet.

Dr. Rivkin (00:44):
Well, it didn't used to be that way, so my training is ENT.I very early on realized that what I really wanted to do was aesthetics and these tools came out, these fillers and toxin, and it was a whole new world that was being born and I thought it was really exciting and really interesting and what I thought was really exciting, really interesting was what can I do without taking someone to surgery? And I started doing things like noses and chins and all these nonsurgical procedures and there was an imperative to explore and refine and develop and kind of get these procedures as safe and as effective as possible because if I can save people a trip to the operating room, I think that's pretty amazing. So that's been essentially my career is just trying to develop and popularize and really let people know about what the power of these procedures are and how good they're recently. However, that job has been very complicated.

Eva Sheie (01:52):
How so?

Dr. Rivkin (01:53):
There's so much disinformation about fillers and toxins and biostimulators out there on social media that it's actually been quite frustrating. People believe all sorts of things and they come into the office and they're like, oh, well I just heard that filler is just awful and is inflammatory and it's going to do all terrible things to my face and it's going to migrate around my face and all sorts of things. It's being promoted by people, sometimes surgeons and plastic surgeons and other people. It's really too bad.

Eva Sheie (02:31):
I've heard a lot of that too. It shows up in the data. I think there was a wild swing in 2024 where hyaluronic acid fillers went down and biostimulators went up, and I think you just pinpointed one of the causes at least of that social media people talking about what's going on with filler. But what has your personal experience been?

Dr. Rivkin (02:54):
Well, that and just a fear not knowing who to believe. I mean, I've been working with these tools for, geez, 22 years, so I know what they do and what they don't do. It's tough because, and I know they're safe and I know they're effective and I know that if you do it right, the results are really quite, very, very good, very precise. But the thing is that some of these guys that are on social media see the side effects. They see the bad work and they fix the bad work, and then they go on social media and they generalize about the things that they've seen as being an issue with fillers or toxins as opposed to being an issue with the hand that delivered those particular fillers and toxins. And it makes people scared. It's too bad. It's unfortunate because people shouldn't be getting facelifts in their early forties or late thirties. They really shouldn't be doing that message. Should not be fillers are dangerous, you should get a facelift instead. That's bonkers.

Eva Sheie (04:01):
When you say it like that? Yeah, it certainly does sound bonkers.

Dr. Rivkin (04:05):
Most of my nose injection practice is revisions. Most of the people that come to me for it to inject the nose are people who have already had 1, 2, 3, 4 rhinoplasties, right?

Eva Sheie (04:19):
Real surgical rhinoplasty,

Dr. Rivkin (04:21):
Surgical rhinoplasties. And they come to me because they're like, they want an alternative. They're like, I don't want to go into the knife again. This has been a very difficult, expensive and horrible experience I want, is there any other options? And a lot of times I can provide those other options because the fillers are so precise and I have temper as well as permanent options.

Eva Sheie (04:45):
Are you known specifically for that?

Dr. Rivkin (04:47):
Yeah, yeah. I'm known specifically for the nose and injecting the nose. And more than anything else, I'm known for revising and helping with post rhinoplasty problems. So I could go on social media and be like, rhinoplasty really sucks. It's just like, look at all these people that are been mangled with rhinoplasty. But I know that's not true because most rhinoplasty results are quite good and I see the problems, but that doesn't mean that everybody's like that. So I dunno. I think it's frustrating.

Eva Sheie (05:24):
It certainly is. The other common thread here is that people are hearing all of this on social media, and I have kind of a strong opinion that not everybody finds their doctor on social media. So do you agree with me or disagree? You do. I

Dr. Rivkin (05:40):
Very much agree with you. I very much agree with you because it's just the problem with social media. You need to talk to people. People look for shortcuts, but there's no shortcuts. You need to do your research, you need to talk to people, and you need to get a sense of who in your community is good and talk to doctors. My patients ask my advice and I give them my honest advice as to who I think is actually quite good and who will communicate well. You know what I mean? Because it's not just technical skills. Also communication. So you want to have somebody who understands what desires you want and doesn't do the opposite of what you're asking for, which can happen if they don't listen. So I'll make those kinds of recommendations. The thing is that going just by social media, social media rewards, extreme views, the rewards, controversy, rewards, stuff like that. And so if you go just by social media, it becomes challenging because are you getting, is the most popular person on Instagram popular because they're so good? Or is the most popular person popular because they have all these controversial views that attract attention, attract social media clicks and all this kind of stuff.

Eva Sheie (07:05):
Well, then the controversy starts to seem like the norm, which it absolutely is not. It's all the outliers, right?

Dr. Rivkin (07:11):
That's right. That's so I think people need to be careful about using social media as their sole source of referral. It's very, very useful of course, to see before and afters to get a sense of the person that you're thinking about going to get a sense of their office. But it shouldn't be the only thing you use.

Eva Sheie (07:32):
I wish that I had not spent so many years of my life thinking about this particular problem, but I think when we're the patient, we want evidence, we want to know where do we get the information that helps us make a good decision. In the past, we had photos. That's great, and we had reviews. We still have both of those things. But I think the bigger challenge is you need the quantity of those things to have confidence. You need a lot of photos and you need a lot of reviews. And then you also need a little bit of knowledge to know what it is that you're looking at, and then compound that with how much noise there is, which is what you're talking about. It's put us in not a very good place. I hear you.

Dr. Rivkin (08:20):
I agree.

Eva Sheie (08:21):
Yeah. Well, we got philosophical. We were supposed to be talking. Well, we are talking about you. I think the way you're thinking about it is really refreshing. And I wonder how do your patients find you and do they say things like, I love you because telling the truth? Or what do they say to you when they show up for the first time?

Dr. Rivkin (08:44):
Some find me on social media and they like that I am fairly straightforward in posts and that I kind of challenge some of the myths that are going around. And I think that's great because then I attract the kind of person that I want to attract and we think similarly, which is nice. Otherwise it's word of mouth. A lot of times it's people who are very happy with their results, telling their friends, this is who you should go to. The other thing that's interesting actually is, and this is new, and this is I think where the future goes, is ai. I was just talking to a patient and just 15 minutes ago, and she was mentioning that, she was mentioning that she was doing research in chat GPT, and I was like, oh, no, this is not great, but this is a established patient of mine, so it's fine. But she was saying that she was kind of wondering about a question, so she was doing some research in chat GPT. I said, okay. And then she said, by the way, she goes to me when I type in nonsurgical rhinoplasty, you are who chat GPT recommends. And I'm like, well, there's clearly no higher, no higher authority. I'm clearly, I'm very pleased.

Eva Sheie (10:11):
That's good. I mean, it does a pretty good job. And I think what I like about those results is they're written in a really friendly, warm way, so it feels like your friend is telling you, but your friend is not very smart and really makes a lot of mistakes. Like last week I was looking for breast surgeon in San Diego and chat, GPT told me the surgeon worked in somebody else's practice altogether where she's never worked. And I thought, wow, if they saw that they would, their heads would explode.

Dr. Rivkin (10:46):
Yeah, it does. It hallucinates quite a bit. So you have to be, I mean, I think this is probably temporary that it'll get much better, but I mean unfortunately, this is the track we're on. There's no denying that AI is our future.

Eva Sheie (11:02):
My friend who's a developer has a scribe tool for an EMR, and so the doctor gives the notes, the scribe ai, the notes right into the chart. Well, he told me on Sunday that the doctor kept calling and saying, these notes are so strange and they're totally inaccurate. I don't know where they came from. And so they figured out that his microphone wasn't on, and he was recording blank files and uploading blank files, and the AI was hallucinating the notes completely from beginning to end.

Dr. Rivkin (11:36):
Oh my God. That's hysterical. Wow. That's impressive. It could lose

Eva Sheie (11:43):
All of the normal practical people in the room said, shouldn't you just reject the file if it's blank? And he was like, what do you mean? No, that's not what it does. What do you mean that's not what it does?

Dr. Rivkin (11:54):
That's crazy. That is crazy. It shouldn't be like that. Yeah. Yeah. Well, we'll see how it goes. But yeah, it's interesting. But I do think that the most, in general, of course, still word of mouth is still the best.

Eva Sheie (12:10):
It's probably more important than it ever has been.

Dr. Rivkin (12:14):
I think so too. Yeah. A lot of, yeah, as you say, there's a lot of noise. That's right. And that's the way around the noise. The person telling you this is a trusted is someone who's trusted and has the experience to tell you about.

Eva Sheie (12:28):
I went there myself, I had a treatment, it was great. They were great. What more evidence do you need than somebody? Where are we going to go? I don't know the answer to that, but my way of helping is to get doctors' voices out there and feed the AI with things that are real. And podcasts do that so well.

Dr. Rivkin (12:51):
Yes, true. I appreciate that. I think that's great. Real information from people who understand and who have experience to talk about it.

Eva Sheie (13:04):
Well, and that's why this podcast exists. We just want to know you. That's really, it's that easy.

Dr. Rivkin (13:12):
Yeah.

Eva Sheie (13:12):
Okay. There's a beautiful photo over your shoulder that's not just a frame with a stock photo in it.

Dr. Rivkin (13:19):
No, no. That's my wife. That's mys my lovely wife. The best decision in my entire life. And we have here, there's a, the other ones

Eva Sheie (13:35):
Two of them.

Dr. Rivkin (13:36):
Yeah, two of them, two boys. One is seven and one is six, and they're in second grade and kindergarten. So they're lovely as well.

Eva Sheie (13:45):
Yeah. Mine are also in second and kinder, and they're just like a barrel of laughs or monkeys depending on the day.

Dr. Rivkin (13:52):
Yes, exactly.

Eva Sheie (13:54):
That's good. How has work changed since they came along?

Dr. Rivkin (13:58):
I try to either take them, if I go to a conference, I try to take them with me, which is fun if she has time because my wife's an architect, so her time is limited, but when she can, they accompany me and then we take a little bit more time and make a little vacation out of it. But the conferences aren't quite as much of a draw these days. I want to be home, I want to see them. I want to hang out with, just spend time with them. So that's the thing. My belief is that they will benefit from having a language, another language. And so I speak Russian, and so I try to get them to be essentially bilingual. And then my wife speaks Chinese and grandma speaks Chinese so they understand Chinese. That's kind of good. So I think that that's good for the future. And their ability to switch languages I think translates into an ability to handle different kinds of situations. I think. We'll see.

Eva Sheie (15:05):
What about your work family? Who's there in the office that supports you?

Dr. Rivkin (15:09):
A lot of people. A lot of people. And it's funny because when I started in on this, my office was, I mean, of course it was much smaller and everything was much just kind of smaller. And I've expanded and I realized that I just kind of felt okay. I just went, well, this is the next step and this is the next step, and this is the next step to expand the business. That's not, not intuitive necessarily, that can run into pressures that have to be managed in different ways. And so it's the business side of this. I didn't have to worry about at the beginning because it was small and the overhead wasn't huge, but now I have to think about this things. I'm supporting 30 people. It's a lot.

Eva Sheie (16:02):
How many of them are providers like yourself?

Dr. Rivkin (16:06):
About seven. Not everybody's full time

Eva Sheie (16:09):
Injectors. Laser. Take us through the services and the people that you have there.

Dr. Rivkin (16:14):
So injections, lasers, devices, energy devices, estheticians. There's a person who does browse, that kind of stuff. So all aesthetic stuff.

Eva Sheie (16:26):
Is there any non-surgical technology that you're excited about or looking forward to?

Dr. Rivkin (16:31):
I've always been excited about skin tightening technologies, but we

Eva Sheie (16:35):
All have.

Dr. Rivkin (16:36):
Yeah, but they've always been disappointing. I got to say. They have not. I've been excited and then I've been let down. I feel like Charlie Brown in the football a lot of

Eva Sheie (16:46):
Times over and over,

Dr. Rivkin (16:47):
Over and over. No, this is the one. This one, this is the one. No, no, no, that's trash. This is the one. This is the one that'll be revolutionary. I don't know. I'm always watching to see what new stuff comes out. I'm no longer quite as interested in being the first one out of the gate with new technology. I have too many very expensive doorstops in my office with devices that I don't use. And technology that's just doesn't live up to expectations. So most of what we do is really injectables as opposed to technology stuff. I find it to be more reliable.

Eva Sheie (17:31):
Well, and the injectable products have come so far too. I think when you and I started working on these things, oh, 20 plus years ago there was just Botox and there was just Restylane and there was anything else. I mean,

Dr. Rivkin (17:48):
There's collagen, but who?

Eva Sheie (17:49):
Collagen?

Dr. Rivkin (17:50):
Nobody wanted that.

Eva Sheie (17:51):
Right. But now there's a whole range across every single brand.

Dr. Rivkin (17:58):
Yeah. I think I was one of the first practices to exclusively focus on non-surgical aesthetics. There was no nurse run med spas back then. Nobody was really focusing on this. There was dermatologists who did this stuff. There was plastic surgeons who did this stuff, but there was very few practices that were specifically focused on non-surgical aesthetics. And I thought that was interesting, and I liked being the person that was really going to devote my practice to it. Nowadays, that's no longer the case. And there's a lot of these practices and there's a lot of these med spas and are quite good, and some are not as much, so it's difficult to know who to go to. It's difficult to know who's good or not.

Eva Sheie (18:51):
Yeah, it certainly is. How did you land in Los Angeles in the first place?

Dr. Rivkin (18:58):
I am from Boston. And I went to school in New York and I went to school in New Haven and my residency was in San Diego. And I thought I had plenty of memories of Boston and New York winters to know that there was no way in hell I was moving out of California. So I liked San Diego, but I wanted more of a city. I wanted more diversity. I wanted more arts and culture, and I had friends in la, so I just kind of settled here and I knew that the lifestyle was what I wanted. It's just kind of a more New England is. There's a culture in New England that's a little more rigid. LA is more accepting and more kind of relaxed about things. So it's interesting. It was a nice transition.

Eva Sheie (20:00):
No regrets, I'm sure.

Dr. Rivkin (20:02):
No, no.

Eva Sheie (20:05):
What did it feel like to go out on your own?

Dr. Rivkin (20:08):
It was exciting and it felt natural and it felt good, and it really felt like this was where I belonged. I just fell into it and it was good. So it's been going on for a while.

Eva Sheie (20:27):
One question I love to ask is, if you've never been to the practice, if you're a prospective patient, what is the experience like coming there for the first time?

Dr. Rivkin (20:37):
I think the experience is warm. I think the experience is we have dogs. Oh yeah. So here's what you don't know about me. I have a cocker spaniel dachshund mix named Sammy, and he's very, very cute. And he's not big. He's a pretty small dog. He's about 13 years old. I've been bringing him to the practice with me every single day for 13 years, and he just lives here. And then some of my employees also bring their dogs over as well. And it's great. And people love it. They absolutely love it. Like little therapy dogs, they know they're sitting in the waiting room and they're kind of nervous. They know they're about to get stuck with needles, and these little dogs come wandering over and they pet 'em and they calm down. I think it's nice for four people, but I like it. I like having those guys around. I think it makes it a more, and because the thing, I want it to be a welcoming, warm, certainly of course, comfortable and boutique kind of place, like the kind of place that you go to for world-class results, but not kind of attitude. I don't need that. So I think that's what people really respond to, that I hire specifically front desk and back office people that are warm, empathetic, and pleasant, and without drama, without attitude. And that's been the brand.

Eva Sheie (22:14):
Well, I don't see the dogs on your Instagram. Why don't they get to be the stars of your social media?

Dr. Rivkin (22:20):
They're in there somewhere. They're not on a daily basis.

Eva Sheie (22:24):
Okay, well here's your reminder to put them up.

Dr. Rivkin (22:27):
There you go.

Eva Sheie (22:29):
I don't see any on the top anyway. I don't see any, but yeah, I was going to say, if there's no pictures, it's not real.

Dr. Rivkin (22:36):
There you go. Will do.

Eva Sheie (22:38):
That's really sweet. Your Instagram is Rivkin, R-I-V-K-I-N_aesthetics. Where else can we find you online?

Dr. Rivkin (22:46):
So the practice page is Rivkin Aesthetics. My main page. My page is Dr. Rivkin.

Eva Sheie (22:52):
Oh, there's the dog.

Dr. Rivkin (22:53):
Yeah. There we go.

Eva Sheie (22:54):
In your profile picture. Oh my gosh. So cute.

Dr. Rivkin (22:58):
Right? He's a good looking guy.

Eva Sheie (23:00):
Yeah. I almost don't want to ask, how did they combine Dachshund and Cocker Spaniel into one word? Like in Dumb and Dumber with the bulldog and the shih tzu.

Dr. Rivkin (23:11):
Know how I combine in one word, Cocker Wiener. That's what he is. He's a cocker wiener.

Eva Sheie (23:19):
That's Fantastic.

Dr. Rivkin (23:21):
So there you go.

Eva Sheie (23:24):
That's Sammy. It's the best thing that's happened to me all day.

Dr. Rivkin (23:28):
There you go.

Eva Sheie (23:30):
Well, thank you Dr. Rivkin.

Dr. Rivkin (23:32):
Of course.

Eva Sheie (23:33):
It was a pleasure hearing from you today, and I look forward to seeing you again soon.

Dr. Rivkin (23:39):
Very good. It's a pleasure. Thank you for having me on. It was fun.

Eva Sheie (23:43):
There's no substitute an in-person appointment, but we hope this comes close. If you're considering an appointment with this provider, be sure you let them know you heard them on the Meet the Injector podcast. Check the show notes for links, including the injector's website and Instagram to learn more. Are you an aesthetic injector or do you know one? You can be a guest on Meet the Injector. Book your free recording session at meettheinjector.com. Meet The Injector is Made with Love in Austin, Texas and is a production of The Axis, theaxis.io.